Get access

An exploratory investigation of real-world reasoning in paranoia



Objectives. Paranoid thinking has been linked to greater availability in memory of past threats to the self. However, remembered experiences may not always closely resemble events that trigger paranoia, so novel explanations must be elaborated for the likelihood of threat to be determined. We investigated the ability of paranoid individuals to construct explanations for everyday situations and whether these modulate their emotional impact.

Methods. Twenty-one participants experiencing paranoia and 21 healthy controls completed a mental simulation task that yields a measure of the coherence of reasoning in everyday situations.

Results. When responses featured positive content, clinical participants produced less coherent narratives in response to paranoid themed scenarios than healthy controls. There was no significant difference between the groups when responses featured negative content.

Conclusions. The current study suggests that difficulty in scenario construction may exacerbate paranoia by reducing access to non-threatening explanations for everyday events, and this consequently increases distress.

Practitioner Points

  • • When working with distress associated with paranoia, practitioners should devote attention to developing coherent narratives where others are viewed as helpful and caring.
  • • Some cases of distress associated with paranoia may result from an uncertain and confused state of mind rather than threatening thought content alone.